Senate panel looks into death of inmate untreated for 2 days

Published 6:00 pm, Wednesday, January 23, 2008

A key senator said Thursday that staff shortages led to conditions that allowed a Texas prison inmate to lay for two days with a broken back in his own filth on the floor of his cell and then die.

"I think there's enough blame to go around," Senate Criminal Justice Committee Chairman John Whitmire, D-Houston, said after a hearing on the death. "The Legislature passes the budget and makes policy. I think the shortage of personnel played a critical role."

Larry Louis Cox, 48, died last Feb. 6, two weeks after a scuffle with guards at the high-security section within the Estelle Unit of the Texas Department of Criminal Justice. The Galveston County Medical Examiner's Office ruled his death a homicide caused by medical neglect after he suffered blunt force trauma.

No one was prosecuted in the case and officials still disagree over who to blame.

The prison system's inspector general said the guards were not responsible, but blamed prison medical staff.

Inspector General John Moriarty said Cox was being combative and hit his head on a bunk and a storage locker. He said Cox was interviewed before he died and acknowledged fault for kicking guards and starting the melee.

"It's my firm belief we got to the bottom of what happened," he said, pointing at a lack of proper medical response within the prison.

Moriarty said investigators came to the "collective conclusion … we had criminally negligent homicide. That's why we moved forward."

"The individual had deteriorated so bad," he said. "Somebody should have done something."

"Looking for somebody to indict in this deal, it's not here, Sen.," Ranger Capt. Antonio Leal told a skeptical Whitmire during the 4 1/2-hour hearing. "There is no one criminally responsible for this man's death.

"This is just one of those circumstances where everything that could have gone wrong did go wrong… Inmates every day play the system, but no one deserved to die like this."

Cox in 1990 was sentenced out of Harris County to 20 years for burglary with intent to commit sexual assault. He picked up another 15 years for murder in 1998 for killing his cellmate at the Stiles Unit in Beaumont.

"The bottom line is it's our responsibility to care for him," Whitmire said.

Cox's head injuries were treated at a hospital in Huntsville but neck fractures weren't found. He was returned to the prison. The prison system probe determined he told officers he had difficulty moving.

A corrections officer gave Cox some Tylenol because the prison clinic was closed for the night. The next morning, he was given two more prescription drugs and was returned to his cell, but he couldn't take any more medicine because of his mobility problems. A patient care assistant recorded that as a refusal to take medication. Another attempt also was written up as a refusal.

Senators on the panel suggested someone with more medical expertise should have been available to assess Cox.

The investigation showed a corrections officer worried about the inmate's condition violated policy and contacted his stepmother, a nurse at the University of Texas Medical Branch at Galveston, which handles prisoner health care. She arranged for a nurse from another prison to examine Cox. That exam led to his transfer to Galveston, where doctors found he had three broken vertebrae and a spinal fracture.

Ben Raimer, the head of correctional managed health care at UTMB, in sometimes contentious exchanges with Whitmire, defended prison medical staff. He pointed to a 50 percent shortage of physicians working in the prison system, an 18 percent shortage of medical practitioners and an 18 percent vacancy rate for nurses.

"They can go anywhere and get a better job and make more money," he said, explaining the shortages.

"Why in the hell ain't somebody telling us these things?" Whitmire shot back. "We're going round and round and nobody's really getting to the root of the problem. Help me."

Raimer said the Legislature last year provided some money for pay raises, but he also noted the sometimes nightmarish work conditions.

He said the Cox case had been "reviewed and reviewed and reviewed" and that disciplinary action had been taken against some of those involved "but we're not sure they did anything wrong."

"The poor (physician's assistant) was guilty by just being present," Raimer said. "This is not fair to our employees."

Whitmire suggested more corrections officers might have allowed for more vigilant checks on Cox.

According to a January 2007 report from the federal Bureau of Justice Statistics, Texas led the nation in prisoner deaths between 2001 and 2005 with 1,933, or nearly 13 percent of all prison deaths. California, with the only state prison population larger than Texas, had 1,672 during the same period. Of all the deaths nationwide, 89 percent were attributed to unspecified medical conditions, with AIDS, suicide and homicide accounting for the bulk of the other deaths. The statistics don't include executions.